Pheochromocytoma: Current Concepts of Diagnosis and Treatment
Authors: ALBERT SJOERDSMA
Journal: Annals of Internal Medicine (1966)

Clinical Staff Conference1 December 1966Pheochromocytoma: Current Concepts of Diagnosis and TreatmentCombined Clinical Staff Conference at the National Institutes of HealthALBERT SJOERDSMA, M.D., PH.D., KARL ENGELMAN, M.D., THOMAS A. WALDMANN, M.D., LEE H. COOPERMAN, M.D., WILLIAM G. HAMMOND, M.D.ALBERT SJOERDSMA, M.D., PH.D., KARL ENGELMAN, M.D., THOMAS A. WALDMANN, M.D., LEE H. COOPERMAN, M.D., WILLIAM G. HAMMOND, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-65-6-1302 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDr. Albert Sjoerdsma: I shall begin this conference by reading excerpts from the case histories of several of our patients."There was" a 6-year-old girl who had perspired excessively since birth and was repeatedly termed an "anxious child" by her pediatricians. After her mother read a newspaper article by Dr. Walter C. Alvarez on causes of excessive sweating, she asked a physician to measure her daughter's blood pressure; it was greatly elevated. A cerebrovascular accident with moderate residual ensued, but relief of symptoms eventually occurred after an operation. Two years later symptoms recurred, and metastatic nodules were visible on the...References1. TISHERMANGREGGDANOWSKI SEFJTS: Familial pheochromocytoma. JAMA 182: 152, 1962. CrossrefMedlineGoogle Scholar2. Leading Article: Pheochromocytoma and thyroid cancer. Brit. Med. J. 2: 549, 1965. CrossrefGoogle Scholar3. GIFFORDKVALEMAHERROTHPRIESTLEY RWWFFTGMJT: Clinical features, diagnosis and treatment of pheochromocytoma: a review of 76 cases. Mayo Clin. Proc. 39: 281, 1964. MedlineGoogle Scholar4. ENGELMANSJOERDSMA KA: A new test for pheochromocytoma. Pressor responsiveness to tyramine. JAMA 189: 81, 1964. CrossrefMedlineGoogle Scholar5. GITLOWMENDLOWITZWOLF SEMRL: The diagnosis of pheochromocytoma. J. Mount Sinai Hosp. N. Y. 28: 159, 1961. MedlineGoogle Scholar6. VON STUDNITZENGELMANSJOERDSMA WKA: Urinary excretion of phenolic acids in human subjects on a glucose diet. Clin. Chim. Acta 9: 224, 1964. CrossrefMedlineGoogle Scholar7. PISANO JJ: A simple analysis for normetanephrine and metanephrine in urine. Clin. Chim. Acta 5: 406, 1960. CrossrefMedlineGoogle Scholar8. PISANOCROUTABRAHAM JJJRD: Determination of 3-methoxy-4-hydroxymandelic acid in urine. Clin. Chim. Acta 7: 285, 1962. CrossrefMedlineGoogle Scholar9. CROUTPISANOSJOERDSMA JRJJA: Urinary excretion of catecholamines and their metabolites in pheochromocytoma. Amer. Heart J. 61: 375, 1961. CrossrefMedlineGoogle Scholar10. CROUT JR: Determination of catecholamines in urine, in Standard Methods of the American Association of Clinical Chemists, vol. 3, edited by SELIGSON, D. Academic Press, New York, 1960, p. 62. Google Scholar11. ROSSEWALDMANN WFTA: A comparison of some physical and chemical properties of erythropoiesis-stimulating factors from different sources. Blood 24: 739, 1964. CrossrefMedlineGoogle Scholar12. BRUNJESJOHNSCRANE SVJMG: Pheochromocytoma: postoperative shock and blood volume. New Eng. J. Med. 262: 393, 1960. CrossrefMedlineGoogle Scholar13. GOLDFEIN A: Pheochromocytoma: diagnosis and anesthetic and surgical management. Anesthesiology 24: 462, 1963. CrossrefMedlineGoogle Scholar14. BISKINDMEYERBEADNER GRMASA: Phaeochromocytoma cured by surgical intervention: clinical management. J. Clin. Endocr. 1: 113, 1941. CrossrefGoogle Scholar15. WATKINS DB: Pheochromocytoma. J. Chronic Dis. 6: 510, 1957. CrossrefMedlineGoogle Scholar16. ENGELMANSJOERDSMA KA: Chronic medical therapy for pheochromocytoma. Ann. Intern. Med. 61: 229, 1964. LinkGoogle Scholar17. SPECTORSJOERDSMAUDENFRIEND SAS: Blockade of endogenous norepinephrine synthesis by alpha-methyl-tyrosine, an inhibitor of tyrosine hydroxylase. J. Pharmacol. Exp. Ther. 147: 86, 1965. MedlineGoogle Scholar18. SJOERDSMAENGELMANSPECTORUDENFRIEND AKSS: Inhibition of catecholamine synthesis in man with alpha-methyl-tyrosine, an inhibitor of tyrosine hydroxylase. Lancet 2: 1092, 1965. CrossrefMedlineGoogle Scholar19. ENGELMANSJOERDSMA KA: Inhibition of catecholamine biosynthesis in man. Circ. Res. 18 (suppl. 1): 104, 1966. Google Scholar20. ORKIN LR: Clinical Management of the Patient in Shock. F. A. Davis Co., Philadelphia, 1965. Google Scholar21. PRICELINDEJONESBLACKPRICE HLHWREGWML: Sympatho-adrenal responses to general anesthesia in man and their relation to hemodynamics. Anesthesiology 20: 563, 1959. CrossrefMedlineGoogle Scholar22. BLACKMCARDLE GWL: The effects of halothane on the peripheral circulation in man. Brit. J. Anaesth. 34: 2, 1962. CrossrefMedlineGoogle Scholar23. MORROWMORROW DHAG: The effects of halothane on myocardial contractile force and vascular resistance. Direct observations made in patients during cardiopulmonary bypass. Anesthesiology 22: 537, 1961. CrossrefMedlineGoogle Scholar24. HALLNORRIS KDFH: Fluothane sensitization of dog heart to action of epinephrine. Anesthesiology 19: 631, 1958. CrossrefMedlineGoogle Scholar25. CRANDELLMYERS DLRT: Pheochromocytoma—anesthetic and surgical considerations. JAMA 187: 12, 1964. CrossrefMedlineGoogle Scholar26. SPROUSEGALINDOMORROW JHAHAG: Influence of various drugs and anesthetic agents on cardiac excitability in man. Anesthesiology 24: 141, 1963. CrossrefGoogle Scholar27. LUCCHESI BR: The effects of pronethalol and its dextro isomer upon experimental cardiac arrhythmias. J. Pharmacol. Exp. Ther. 148: 94, 1965. MedlineGoogle Scholar28. SCOTTRIDDELLBROCKMAN HWDHSK: Surgical management of pheochromocytoma. Surg. Gynec. Obstet. 120: 702, 1965. MedlineGoogle Scholar29. HORWITZSJOERDSMA DA: Some interrelationships between elevation of blood pressure and angina pectoris. Hypertension XIII. Proceedings of the Council for High Blood Pressure Research. American Heart Association, Inc., New York, 1965, p. 39. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Bethesda, MarylandThis is an edited transcription of a combined clinical staff conference at the Clinical Center, Bethesda, Md., by the National Heart Institute, National Institutes of Health, Public Health Service, U. S. Department of Health, Education, and Welfare.Requests for reprints should be addressed to Albert Sjoerdsma, M.D., Chief, Experimental Therapeutics Branch, National Heart Institute, Bldg. 10, Rm. 7-N-260, National Institutes of Health, Bethesda, Md. 20014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByPreoperative intravenous rehydration for patients with pheochromocytomas and paragangliomas: is it necessary? A propensity score matching analysisPerioperative Aspekte in der Behandlung Katecholamin-produzierender TumorenPerioperative Management of Adrenalectomy and Inferior Vena Cava Reconstruction in a Patient With a Large, Malignant Pheochromocytoma With Vena Caval ExtensionPrise en charge anesthésique de la surrénalectomie pour phéochromocytome : « s'accommoder d'une controverse débutante »Point of controversy: perioperative care of patients undergoing pheochromocytoma removal–time for a reappraisal?CLINICAL COURSE OF THE PATIENT WITH MALIGNANT PHEOCHROMOCYTOMA WHO WAS TREATED ON CVD CHEMOTHERAPY AND .ALPHA.-METHYL-P-TYROSINEManagement of paroxysms of hypertension in patients with phaeochromocytomasPhaeochromocytomaA Large Pheochromocytoma seen on Dynamic Bone ScintigraphySimultaneous determination of plasma catecholamine metabolites (homovanillic acid, 3,4-dihydroxy phenyl acetic acid, 3-methoxy-4-hydroxy-phenylglycol) using liquid chromatography with amperometric detectionSensitive determination of 3-methoxy-4-hydroxyphenylglycol (MHPG) in human plasma by HPLC with electrochemical detectionBladder Pheochromocytoma in a 10-Year-Old GirlBladder Pheochromocytoma in a 10-Year-Old GirlDetermination of 3-methoxy-4-hydroxyphenylethylene glycol in urine using reversed-phase liquid chromatography with column switching and electrochemical detectionIntraoperative and Postoperative Care of Unsuspected Pheochromocytoma in Medullary Thyroid CancerPediatric malignant pheochromocytomaPheochromocytomaHypertensive crises induced by treatment of malignant pheochromocytoma with a combination of cyclophosphamide, vincristine, and dacarbazineApparent polycythaemia: diagnosis, pathogenesis and management9 Phaeochromocytoma: diagnosis and managementApparent polycythaemiaDiagnostic problems in pheochromocytomaAdrenal and Pituitary EmergenciesPreoperative and Surgical Management of PheochromocytomaManagement of PheochromocytomaRole of 131 I‐metaiodobenzylguanidine in the localization of suspected phaeochromocytomasSystemic hemodynamics in patients with pheochromocytomaCase 46-1988α-Adrenergic BlockersPheochromocytomaBlue rubber bieb naevus syndromePheochromocytoma, polycythemia and venous thrombosisL'alpha-méthyl-paratyrosine dans le traitement des phéochromocytomes malinsHematologic Abnormalities in Patients with Endocrine and Metabolic DisordersReversibility of Catecholamine-Induced Dilated Cardiomyopathy in a Child with a PheochromocytomaHypertension in pregnancy complicated by cardiorespiratory and neurological impairmentPheochromocytomaHemodynamic Monitoring in Severe Pregnancy-Induced HypertensionPlasma gut hormone levels in 37 patients with pheochromocytomasClinically silent congenital adrenal hyperplasia masquerading as ectopic adrenocorticotropic hormone syndromeCase 6-1986Hypertensive crisis immediately after complete removal of phaeochromocytomaWatery diarrhea syndrome due to an adrenal pheochromocytoma secreting vasoactive intestinal polypeptidePhaeochromocytoma removal and postoperative hypoglycaemiaInfluence of Pre-operative Treatment with Phenoxybenzamine on the Incidence of Adverse Cardiovascular Reactions during Anaesthesia and Surgery for PhaeochromocytomaCase 9-19858 PhaeochromocytomaThe Blood Volume in Pheochromocytoma Patients before and during Treatment with PhenoxybenzamineDiagnosis of PheochromocytomaMALIGNANT PHAEOCHROMOCYTOMA: CLINICAL, BIOCHEMICAL AND SCINTIGRAPHIC CHARACTERIZATIONMultiple endocrine neoplasia syndromesPheochromocytoma and PrazosinJOHN P. NICHOLSON Jr., M.D., E. DARRACOTT VAUGHN Jr., M.D., THOMAS G. PICKERING, M.D., LAWRENCE M. RESNICK, M.D., JOSEPH ARTUSIO, M.D., HOLLIS D. KLEINERT, Ph.D., JORGE A. LOPEZ-OVERJERO, M.D., JOHN H. LARAGH, M.D.Drug Information Analysis ServiceMarked increase in 24-h urine vanillylmandelic acid in a patient after coronary by-pass surgery: Need for cautions interpretationIntrapericardial pheochromocytomaExcretion of Adrenaline, Noradrenaline, Vanilmandelic Acid and Metanephrines in 64 Patients with PheochromocytomaThe role of the adrenal gland in hypertensionUrinary 3-methoxy-4-hydroxyphenylglycol determination using reversed-phase chromatography with amperometric detectionMalignant pheochromocytoma. Severe clinical exacerbation and release of stored catecholamines during lymphoma chemotherapyThe management of the patient with catecholamine excessPersistent hypertension after resection of a pheochromocytomaIncreased 24-hour urine vanillylmandelic acid in patients without pheochromocytomaLaboratory Diagnosis in HypertensionPheochromocytomaNebennierenmarkPolycythemia vera in childhood: Case report and review of the literatureRandom one-hour urine catecholamine and 4-hydroxy-3-methoxymandelic acid assays for diagnosis of pheochromocytomaEndogenous levels of free and conjugated urinary 3-methoxy-4-hydroxyphenylethyleneglycol in control subjects and patients with pheochromocytoma determined by reversed-phase liquid chromatography with electrochemical detectionCatecholamines in PheochromocytomaDiagnosis and Perioperative Management of PheochromocytomaAllgemeine und endokrinologische Laboratoriumsdiagnostik beim HochdruckPhäochromozytomAdrenal neoplasmsHypertension: Diagnostic Test StrategiesDiagnoisis of neural crest tumors by reversed-phase high-performance liquid chromatographic determination of urinary catecholamine metabolitesDrug Information Analysis ServiceCirculating and Urinary Catecholamines in PheochromocytomaHaemodynamics in phaeochromocytomaDiagnosis and localization of pheochromocytomaMalignant pheochromocytoma in childhood: Report of a case with familial neurofibromatosisLocalization of Pheochromocytoma by Computerized Axial TomographyPostoperative Management of Patients with PheochromocytomaPhaeochromocytoma with nocturnal elevation of blood pressure.Medullary thyroid carcinoma and pheochromocytoma accompanied with nodular hyperplasia in multiple endocrine neoplasia type 2Pheochromocytoma of the urinary bladder: A broad clinical spectrumPhaeochromocytomaPheochromocytoma: Recent experience with detection and managementChildhood pheochromocytomaPheochromocytoma and Renovascular HypertensionThe Royal Australasian College of Physicians Scientific Meeting, 1976Case 40-1976De subitaneis mortibus. XIX. On the cause of sudden death in pheochromocytoma, with special reference to the pulmonary arteries, the cardiac conduction system, and the aggregation of platelets.Catecholamines and the Sympathoadrenal SystemLabile methyl balances for normal humans on various dietary regimensSurgery of the AdrenalsAutonomic Dysfunction as a Problem in the Treatment of TetanusThe Office Management of HypertensionPhaeochromocytomaPheochromocytomaPreoperative Blood Transfusion In The Safe Surgical Management Of Pheochromocytoma: A Review Of 46 CasesMedullary Carcinoma of the Thyroid Gland: Use of Biochemical Parameters in Detection and Surgical Management of the TumorEFFECTS OF NEOPLASMS ON RENAL ELECTROLYTE FUNCTIONRESULTS OF SCREENING FOR PILÆOCHROMOCYTOMA IN 17 HYPERTENSIVE PATIENTS WITH EPISODIC SYMPTOMSHypertension in ChildhoodDiastolic hypertension corrected by operation: A reviewExtra-adrenal pheochromocytoma causing renal artery stenosis Relationship to hypertension and renin levelsCase 19-1973Prolonged survival in malignant pheochromocytoma of the organ of zuckerkandl with pharmacological treatmentReferencesDiagnosis of Gastrointestinal Cancer: Current Status and Recent ProgressTherapy of Complicated Arterial HypertensionPhaeochromocytoma and Other Catecholamine-Producing TumoursCatecholamines and Associated Metabolites in Human UrineManagement of anaesthesia for phaeochromocytomaManagement of patients with pheochromocytomaPheochromocytoma Associated with Parathyroid Adenoma. Report of a Case and Review of LiteratureDifferential diagnosis of etiologic types of hypertensionBiochemical Procedures in Different Forms of CancerNon-visualization of the Kidney Due to A Ureteral PheochromocytomaPheochromocytoma masquerading as pre-eclamptic toxemiaFamilial medullary thyroid carcinoma, pheochromocytoma, and parathyroid adenoma (Sipple's syndrome)Study of a kindredThe Management of Hypertension Associated with Disorders of Function of the Endocrine Glands ("Endocrine Hypertension")Malignant Pheochromocytoma with Pleural Metastasis of Unusually Long DurationElective Surgery in Hypertensive Patients — Preoperative ConsiderationsExtra-adrenal pheochromocytomaPheochromocytoma: Total Patient ManagementA Physiologic Approach to Curable HypertensionArteriographic Appearances of PhaeochromocytomasRationale and Indications for Preoperative Adrenergic Receptor Blockade in PheochromocytomaIntracranial Pheochromocytomas (Active Glomus Jugulare)The Biochemical Basis of Adrenal SurgeryHypertensive CrisisPheochromocytoma and Hyporesponsiveness to Thyrotrophin in a 46 XY Male with Features of the Turner PhenotypeCHARLES E. BECKER, M.D., SAUL W. ROSEN, M.D., PH.D., KARL ENGELMAN, M.D.CATECHOLAMINES, THEIR PRECURSORS AND METABOLITES5 The Biosynthesis and Metabolism of the CatecholaminesProgress in the Diagnosis of Secondary HypertensionRecent Advances in the Medical and Surgical Treatment of HypertensionPheochromocytomaPlasma Volume in Men with Essential HypertensionFurther Evaluation of the Tyramine Test for PheochromocytomaPheochromocytomaExaggerated Urinary Norepinephrine Response to Tilt in PheochromocytomaDiagnosis of PheochromocytomaCatecholamine-Secreting Tumours 1 December 1966Volume 65, Issue 6Page: 1302-1326KeywordsArrhythmiaAttentionBlood plasmaLaboratory testsMedical servicesOintmentsPheochromocytomaPrevention, policy, and public healthStrokeTumor resection Issue Published: 1 December 1966 PDF DownloadLoading ...